A discussion with someone recently about the stigma of mental illness as I have personally experienced it, has led me to do some soul searching. I think both of us eventually came to the same conclusion… that perhaps self-stigma has been the biggest issue for me. That’s not to say that I haven’t suffered at the hands of the cultural distaste of anything related to mental illness, or that institutional stigma hasn’t affected me. There have been times when social stigma has hurt, and often the result has been damaged, if not ended relationships. But I realise that I have consistently applied self-stigma to myself for as long as I have had a mental illness, actually probably longer and that may have prevented me from getting the help I needed earlier.
The Mental Health Foundation of New Zealand, in their document Fighting Shadows suggest that self, or internalized stigma is:
“…internalised feelings of guilt, shame, inferiority, and the wish for secrecy experienced by those who live with a mental illness… Self-stigma is a belief in negative stereotypes about a group to which one belongs and the application of those beliefs to oneself, thereby undermining one’s self-efficacy.”
(Watson and Corrigan, 2001)
My guess is that what this means is that I internally hold negative ideas about mental illness, which I apply to myself (and that if I was applying those ideas to others then it would be social stigma). That’s the understanding I’m going to use for now, and I have to say I feel less than comfortable with this thought. Regular readers know that I have discussed the issue of stigma regularly. It is something that I feel very strongly about, and wanting to fight it, is the reason behind a lot of the things I do.
What I need to understand is why I have those stereotypes and why I apply them to myself. I don’t pretend to think I’m going to satisfactorily answer that for myself here, but it’s a good place to start.
My mother always used to tell me that I was my own worst enemy. I’m not sure exactly what she meant by that, as Mum and I have never been known to have the sort of conversations that might see that answered. Reality was more that the statement was made and that was the end of the conversation. No doubt both of us were contributors to that.
I can remember when I was first diagnosed with depression, one of my most common thoughts was:
“I can accept anyone else having depression
but I can’t accept it in myself.”
Somehow I thought I was immune. It would never happen to me. I was 28 at the time and right through my life I had been surrounded by people with mental illnesses. A lot of that exposure came through my father’s job which extended to having church people in and out of our home. At high school, I was friends with a girl who had Anorexia. We were never close, but she was the only person I was aware of in a school of one thousand girls who had a mental illness. No doubt there were others, but it wasn’t something ever discussed.
When I left school I went straight into a job where I was working closely with a lot of people with mental illness and addiction issues. Actually I gained a reputation in the office for being one of the few staff who could handle the particularly difficult clients, and so I was often assigned clients that no one else wanted to handle. I enjoyed working with these people, and other staff couldn’t quite understand that.
Then I got to 28 and discovered I was sitting in a psychiatrist’s office talking about my failing mental health. Straightaway I could accept it for anyone else, but not for me. Things like that didn’t happen to me.
I think that all these people with mental illnesses, who surrounded me from a young age, were also a step removed from me. They weren’t my family, and they weren’t my personal friends. Mostly they were clients of my father’s or later, my own clients. It’s almost like it wasn’t personal so it couldn’t affect me personally. By that time I had a number of friends who had mental illnesses, and again that was perfectly okay. I could accept their illness and often did a lot to support them. But that was them, not me.
Why was it okay for them,
but not for me?
At this point I admit that I am guessing. I don’t understand why I set one rule for others but another for myself. Why could I have compassion for others, but be angry at myself for what I see as weakness?
What springs to mind is the first person whose mental illness had a direct effect on my wellbeing. I was only 14 when I became the target of a stalker who had schizophrenia. He was one of my father’s clients. Dad would welcome him to our home because he wanted to help the guy. The problem was that my father didn’t realise what danger he was putting me in. When I left home at 18, the man followed me, as he did every time I shifted trying to keep one step ahead of him for the next 14 years.
I was literally afraid of this man. He threatened me ,but never lay a hand on me. But the damage he did to my mind in that time, along with other things happening in my life, was huge. Actually it was only nine months after I finally felt I was free from him (by shifting cities) that I was being diagnosed with my own mental illness. I’m sure that’s not simply a coincidence.
The man was regularly in and out of the local psychiatric hospital because of his illness, usually because he had taken himself off his medication. The times he was in hospital were the best times for me. Sometimes I got phone calls or letters, but mostly I was free while he was behind a locked door.
It make senses to me then why the last thing I would want would be to be diagnosed myself, as I might end up in hospital with him. Even figuratively a diagnosis would put me in the same camp as him. If I was the same as him, then somehow I was in more danger.
The second thing that comes to mine is that on several occasions I tried to talk to his mental health workers, to help get them to help me be safe from him. Actually each time I tried I had the Privacy Act quoted at me, and they wouldn’t even listen to me. I didn’t want information about him. I wanted them to know what he was doing. But the mental health system was not interested in the harm he was causing me. Again it would make sense why I wouldn’t want to diagnosed myself, because clearly (to me anyway) the system was not interested in helping or protecting me.
What you’ve just read is me thinking out loud. Obviously there is no audio link with this post but I’ll leave you to imagine that I have been tossing ideas with you. This self stigma hindered me from getting help from medical services but even when I began to accept that actually it was okay for me to have a mental illness, I perhaps unconsciously used the stigma to make it hard for myself to get other types of help. There was a lot of help at university for people with disabilities, including mental illness, but I struggled to seek it out because I didn’t look sick. It was me that put that barrier up, no one else.
Considering self stigma is not an easy one. I am a little embarrassed, but I wonder how many others might struggle, unknowingly even, with our own attitudes that prevent us getting the help and support we need. It doesn’t take away the problem of the stigma we get from other sources, but I’m realising that I have to start with myself. How can I expect others not to stigmatize me when I do it to myself?
“Never forget that once upon a time, in an unguarded moment, you recognized yourself as a friend.”
― Elizabeth Gilbert
- Fighting Shadows: Self-Stigma and Mental Illness (mentalhealth.org.nz)
- Demolishing Stigma (infinitesadnessorhope.wordpress.com)
- Stigma (Passions Profile Challenge #6) (infinitesadnessorhope.wordpress.com)
- Mad, Bad or Just Different (infinitesadnessorhope.wordpress.com)
- Remove the stigma (thehindu.com)
- Dear “Experts” (prideinmadness.wordpress.com)